THE SYMPATHETIC SYSTEM 69 



abdomen is not prominent; the musculature can be made 

 out. The sexual organs, while reduced in volume, are 

 harmonious with the rest of the organism. The cartilages 

 are fixed. There is no mental backwardness. To give 

 the description of Meige, these cases are miniature men. 

 Baur has designated these cases under the name of cheti- 

 vism. This description allows us to understand the 

 difference between the infantilism of Brissaud and that 

 of Lorain. 



B. IN ADULTS. 



The symptoms of abortive myxedema studied by 

 Thibierege are even more marked than in childhood. 



The complexion is yellow; the eyelids are puffy, partic- 

 ularly in the morning. The hair turns gray early and 

 falls from the forehead and the top of the cranium. The 

 eyebrows are scarce, the mustache is scanty, the beard 

 grows unequally, the hands and feet show an indurated 

 edema and appear swollen and often show signs of vaso 

 motor disturbances: acrocyanosis, syndrome of Raynaud, 

 etc. The skin of the extremities is dry, coarse, thick and 

 scaly, sometimes having the appearance of ichthyosis. 

 The individual has a tendency to obesity. The pulse is 

 weak and the blood pressure is low. 



Hertoghe, then L. Levi and H. de Rothschild, have 

 described a certain number of minor signs which are 

 evidences of thyroid insufficiency. The most important 

 are the following: 



1. CALORIFIC DISTURBANCES. Cases of hypothy- 

 roidism are very sensitive to cold. Not only do they have 

 cold extremities, but they feel the desire to warm them- 

 selves up and cover themselves excessively at night. 

 Their body temperature is, moreover, often below normal. 

 Sometimes towards 4 or 5 o'clock they have chills, partic- 

 ularly in the region of the back (Hertoghe). 



